Vascular Disease for Progressive Care Certified Nurse (PCCN)

Vascular Disease

Definition/Etiology:

• Definition
  • partial or total occlusion of an artery
• PCCN Test focus
  • PAD – arms/legs
  • Carotid Artery Stenosis
• Etiology
  • Atherosclerosis – Causes
    • HTN
    • Smoking
    • DM

Pathophysiology:

• Atherosclerosis
  • Fatty material (i.e., plaque) builds up on the walls of the arteries and makes them narrower
  • Stiff arteries = low FLOW
  • Think of a hose

Noticing: Assessment & Recognizing Cues:

• Subjective Cues
  • PAD
    • Chronic vs Acute
      • Chronic = intermittent claudication – Pain increases with exercise
        and decreases with rest
      • Acute = Sudden
  • Carotid Arterial Stenosis
    • Asymptomatic until Stroke
• Objective Cues
  • PAD
    • ankle-brachial index
    • Neurovascular 5 P’s
    • Poor skin integrity
  • Carotid Arterial Stenosis
    • Stroke-like symptoms

Interpreting: Analyzing & Planning:

• Labs
  • Cholesterol
  • Lipids
• Diagnostics
  • Traditional Doppler Ultrasound
  • Duplex Ultrasound – looks closer at bloodflow
  • Ankle-Brachial Index (PAD)

Responding: Patient Interventions & Taking Action:

• Pharmacological Interventions
  • Antihypertensives
  • Statins
  • Calcium Channel Blockers
  • Narcotics
• Non-Pharmacological
  • Angioplasty/Balloon with possible Stent
  • Endarterectomy
  • Bypass

Reflecting: Evaluating Patient Outcomes:

• ABCs
• PAD
  • Neurovascular 5 P’s
• Carotid Artery
  • Cranial Nerves
  • LOC
  • PERRLA
  • Visual Changes
  • Dysphasia
  • Aphasia
  • Headache
• All procedures
  • Post-Op: Infection or Bleeding
  • Smoking cessation

Linchpins (Key Points):

• Notice
  • Peripheral or Cerebral symptoms
• Interpret
  • Labs & Vascular studies
• Respond
  • Pharmacology & Procedure
• Reflect
  • Perfusion + Post – Surgical